超声引导下髂筋膜间隙阻滞联合瑞马唑仑全麻对老年髋关节置换术患者血流动力学及术后认知功能的影响OA
Effect of Ultrasound-Guided Fascia Iliaca Compartment Block Combined with Remimazolam General Anesthesia on Hemodynamics and Postoperative Cogni-tive Function in Elderly Patients Undergoing Total Hip Arthroplasty
目的 探讨老年髋关节置换术(THA)患者采用超声引导下髂筋膜间隙阻滞联合瑞马唑仑全麻对血流动力学及术后认知功能的影响.方法 选取我院2024年2月至2026年2月收治的120例老年THA患者,按随机数字表法分为两组,各60例.两组患者均行THA治疗,对照组实施全麻联合超声引导下髂筋膜间隙阻滞,观察组采用超声引导下髂筋膜间隙阻滞联合瑞马唑仑全麻.比较两组围术期指标[麻醉清醒时间、拔管时间以及麻醉监护室(PACU)滞留时间]、血流动力学(平均动脉压、心率)、简易智力状态检查量表(MMSE)评分、视觉模拟评分法(VAS)评分及不良反应.结果 观察组麻醉清醒时间为(8.25±2.09)min、拔管时间为(14.21±2.58)min、PACU 滞留时间为(19.08±4.62)min,分别短于对照组的(12.77±3.54)min、(18.42±4.61)min、(32.35±7.13)min(P＜0.05);相较于对照组,观察组插管时、手术开始5 min、术毕时血流动力学指标均更高,术后12 h、24h认知功能评分均更高,疼痛评分均更低(P＜0.05);两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 超声引导下髂筋膜间隙阻滞联合瑞马唑仑全麻更利于维持老年THA患者血流动力学稳定,缩短苏醒时间,减轻术后疼痛和认知功能损伤,且不会增加不良反应,值得临床推广应用.
Objective To investigate the effect of ultrasound-guided fascia iliaca compartment block combined with remimazolam general anesthesia on hemodynamics and postoperative cognitive function in elderly patients undergoing total hip arthroplasty(THA).Methods A total of 120 elderly patients undergoing THA in our hospital from February 2024 to February 2026 were selected and randomly divided into two groups using a random number table method,with 60 cases in each group.Both groups underwent THA.The control group received general anesthesia combined with ultrasound-guided fascia iliaca compartment block,while the observation group received ultrasound-guided fascia iliaca compartment block combined with remimazolam general anesthesia.Perioperative indicators[anesthesia awakening time,extubation time,and post-anesthesia care unit(PACU)length of stay],hemodynamic parameters(mean arterial pressure,heart rate),Mini-Mental State Examination(MMSE)scores,Visual Analog Scale(VAS)scores,and adverse reactions were compared between the two groups.Results The anesthesia awakening time,extubation time,and PACU length of stay in the observation group were(8.25±2.09)min,(14.21±2.58)min,and(19.08±4.62)min,significantly shorter than[(12.77±3.54)min,(18.42±4.61)min,(32.35±7.13)min in the control group,respectively(P＜0.05).Compared with the control group,the observation group showed higher hemodynamic parameters at intubation,5 min after surgical incision,and at the end of surgery;higher cognitive function scores at 12 h and 24 h postoperatively;and lower pain scores(P＜0.05).No significant difference showed in anesthesia safety between the two groups(P＞0.05).Conclusions Ultrasound-guided fascia iliaca compartment block combined with remimazolam general anesthesia in elderly patients undergoing THA is more beneficial for maintaining hemodynamic stability,shortening recovery time,reducing postoperative pain and cognitive impairment,without increasing adverse reactions,which is worthy of clinical promotion and application.
任子豪;凌云志
蚌埠医科大学第一附属医院麻醉科,安徽 蚌埠 233000蚌埠医科大学第一附属医院麻醉科,安徽 蚌埠 233000
医药卫生
老年髋关节置换术超声引导髂筋膜间隙阻滞瑞马唑仑全麻血流动力学认知功能
Elderly total hip arthroplastyUltrasound guidanceFascia iliaca compartment blockRemimazolamGeneral anesthesiaHemodynamicsCognitive function
《临床医学工程》 2026 (6)
721-724,4
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